ONLINE COMMENT: It is a confidence booster as sometimes it looks alien-like down there and it does make you feel ashamed and not comfortable in being naked.

ONLINE COMMENT 2: My right labia has a tendency to tuck itself into the labia majora, making hygiene an issue but every so often, it'll hang out and rub against my underwear.

ONLINE COMMENT 3: I always thought I was some kind of freak or something, my va-jay-jay started looking weird when I went through puberty and at first it was just one side a little longer and I didn't know why it was like that.

SARAH DINGLE: Like any surgery, labiaplasty carries risks, including scarring and infection.

The problem is that the reasons for labiaplasty aren't always medical, according to Dr Rebecca Deans.

REBECCA DEANS: They want to even up their labia and more recently requests have come in from women who just feel that their labia are too large and would like to have these reduced surgically. There has been a marked increase over the past few years with about a doubling of these procedures over the last ten years.

SARAH DINGLE: Labiaplasty and vaginal reconstruction surgery, or vulvoplasty, are listed under the same item number on Medicare but Dr Deans says there's no doubt it's labiaplasty which is skyrocketing.

To claim for labiaplasty, a woman needs a GP referral.

REBECCA DEANS: I think women are requesting referral from their general practitioners. I don't think that the general practitioners are concerned about women's labia or bringing it up.

SARAH DINGLE: Do GPs themselves know what is the normal look or range of women's labia?

REBECCA DEANS: Probably some GPs that have a good experience with the normal look however you can go through general practice training and perhaps not examine a women's genitalia particularly often.

SANDRA MORRIS: More women are watching porn and what we know about porn that is that there is a particular look that is being used, if you like, and often that's been photo-shopped and so what they think they should look like and what women really look like are two completely different things.

SARAH DINGLE: Sandra Morris is from Melbourne-based heath service Women's Health in the North.

SANDRA MORRIS: It's concerning because it is not for a medical reason necessarily. It is not about improving a women's sexual and reproductive health. It is really about appearance.

SARAH DINGLE: Some women do have genuine medical reasons for labiaplasty.

But Western Australian plastic surgeon Dr Tim Cooper says the majority of women have labiaplasty due to aesthetic concerns.

TIM COOPER: Around 5 per cent of patients I might refuse to do surgery on. If I get the impression they are unusually obsessed about what is otherwise a normal anatomy then I'll tell them directly and quite commonly somewhere in the past they've had an adverse comment.

I recall one lady who'd had an adverse comment at childbirth about the size of her labia and she'd fixated on that adverse comment. Sometimes in relationship break-ups if you explore it you find that there was an adverse comment made at some stage.

SARAH DINGLE: It's not just women who are anxious about their labia. Sydney based Dr Rebecca Deans says she's fielding requests from young girls.

REBECCA DEANS: Thirteen is the youngest here in Australia. With this particular 13-year-old I only saw the patient on her own and reassured her and explained to her that really we should include her mother in this conversation and she agreed.

So I invited the mother into the consultation room and then unfortunately the mother then said oh perhaps you should have surgery. I'm a beauty therapist and I wax a lot down below and I think that she looks a bit unsightly and I'd like her to have surgery.

SARAH DINGLE: Dr Deans says that the long-term consequences of labiaplasty aren't yet known and she sees some parallels between labiaplasty and female genital mutilation.

REBECCA DEANS: In its extreme form it's complete removal of the clitoris as well as the labia however there are more moderate forms if you like of female genital mutilation that are only described as cutting or nicking of the genitalia and in fact, it is not that dissimilar and I really wonder about that grey area that exists between the two because obviously FGM is illegal in Australia.

SARAH DINGLE: The Federal Health Department says the Medical Services Advisory Committee is currently reviewing the Medicare rebate for labiaplasty.

Related Links

From the Archives

Sri Lanka is now taking stock of the country's 26-year-long civil war, in which the UN estimates as many as 40,000 Tamil civilians may have been killed. This report by the ABC's Alexander McLeod in 1983 looks at the origins of the conflict as it was just beginning.